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This is VAERS ID 276137

Case Details

VAERS ID: 276137 (history)  
Form: Version 1.0  
Age: 21.0  
Gender: Female  
Location: Massachusetts  
Vaccinated:2006-12-15
Onset:2006-12-15
   Days after vaccination:0
Submitted: 2007-04-06
   Days after onset:111
Entered: 2007-04-09
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0961F / UNK RA / IM

Administered by: Other       Purchased by: Other
Symptoms: Injected limb mobility decreased, Paraesthesia, Vomiting
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: albuterol; hormonal contraceptives
Current Illness: Asthma
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0703USA00630

Write-up: Information has been received from a Registered Nurse (R.N.) concerning a 21 year old female patient with asthma who on 15-DEC-2006 was vaccinated IM in her right arm with a dose of Gardasil, lot #654389/0961F. Concomitant therapy included hormonal contraceptives (unspecified) and albuterol inhaler (unspecified). The patient has had difficulty lifting her right arm since she was immunized in that arm on 15-DEC-2006. The patient also experienced tingling in her arm, nausea, and vomiting after the injection. The patient was treated with physical therapy. The patient had not recovered as of the report date. Additional information has been requested.


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